Physicians Request For Directed Donation: Fill & Download for Free

This is actually a topic on which I've done a fair bit of research, although my advice will be specific to the state of California. (I've investigated some of the options above with a few friends who were trying to conceive and wanted to use me as a known donor.) Here's what I've learned:Sperm BanksBy far the best-understood and easiest option, probably the safest option, and undoubtedly the option most doctors would recommend. You pick someone you like from a catalog, optionally pay for a detailed profile, order sperm, and use whatever method you and your doctor chose (ICI, IUI, IVF, etc.)Advantages:You can easily browse potential donors online.You don't have to do any screening yourself. All of the STD, genetic, andphysical health screenings are done by the bank and rolled into the per-vial price.If you care about credentials, some banks set up locations near elite universities to draw upon well-credentialed but impecunious students. (Not all banks will tell you where people went to school, however.)Some people use DonorSiblingRegistry to connect with people who shared adonor, so you might be able to find your sons' or daughters' half-siblings, if you like.You can safely assume that reputable banks care about their reputation and will try to catch whatever disorders they can. (There are occasional stories in the press about serious genetic defects that slipped through the screening, but those are rare---probably much more so than the rate of genetic defects in children of couples who did not have genetic counseling---which is to say, most of them.)A sperm-bank donor can't flake out at the last minute, as a known donor might. (They might, however, sell out -- in other words, have no vials left if and when you want to give your son or daughter a full sibling. Some banks will let you purchase and store your extra vials from your donor in advance to prevent that. Some banks will also offer to contact "retired" donors to see if they're willing to donate again---although they might not be willing or able to do so.)DisadvantagesHigh upfront costs: per-vial prices vary from under $300 dollars for a non-identity-disclosure vial at some banks to up to $700 per vial at others. If you take five tries to carry to term and use two vials from such a bank each time, you'll be out $7,000. (That's negligible compared to the lifetime cost of raising a child (or litigating a known-donor relationship that turns sour), but it's still not cheap.)Sperm suffers in the freezing process, so you'll probably take more tries toconceive, which can get expensive, per above. (This concern is irrelevant if you're using IVF.) If you're a bit older and want to conceive via ICI or IUI before you have to use IVF, this could also be a concern.Per above, the economics of the donation industry demand that banks recruit donors who have (a) very high sperm counts, so they can produce the most vials per donation and (b) sperm that survive freezing well. As far as I know these traits are more or less randomly distributed, so if you want something very specific requirements (e.g., X height with Y educational credentials and Z ethnic background), some banks may not be able to accommodate your criteria simply because not enough men met those criteria, were willing to donate, and had sperm that was economical for the bank to market.In most cases, you won't get to meet the donor until the child is 18 (if you choose an ID-release donor), ask them questions, or, for some banks, even see a photo of the donor as an adult.Overall, if you just want to have a kid without a lot of hassle, don't mind paying, and aren't enormously concerned about the precise details of the donor, a bank is probably the easiest option.But what if you want to know more about the donor? How do they look? What kind of person are they? What if you want to be able to ask them questions as the child grows up? What if you want them to take an unusual genetic test?For that, you'll probably want a known donor---which describes the rest of the options (one-night stand, Craigslist, Internet forums), I think it's helpful to break them down along two axes instead of considering them individually: how is thedonation furnished and how did you meet the person?1) How is the donation furnished? E.g., are you actually having intercourse with the donor, or are you using a doctor or clinic?Human beings typically reproduce via intercourse, but if you live in the U.S., mixing sex and sperm donation could be a very bad idea. Your donor could be considered the children's natural father, held liable to pay child support, and could accordingly demand joint custody in court.Fortunately, if you live in California, there's a statutory provision that protects donors and recipients: if you use a doctor or a clinic, the donor is not considered the child's father. That means he isn't responsible for child support and can't sue for custody. More specifically:California Family Code Section 7613http://law.onecle.com/california/family/7613.html(a) If, under the supervision of a licensed physician and surgeon and with the consent of her husband, a wife is inseminated artificially with semen donated by a man not her husband, the husband is treated in law as if he were the natural father of a child thereby conceived. The husband's consent must be in writing and signed by him and his wife. The physician and surgeon shall certify their signatures and the date of the insemination, and retain the husband's consent as part of the medical record, where it shall be kept confidential and in a sealed file. However, the physician and surgeon's failure to do so does notaffect the father and child relationship. All papers and records pertaining to the insemination, whether part of the permanent record of a court or of a file held by the supervising physician and surgeon or elsewhere, are subject to inspection only upon an order of the court for good cause shown.(b) The donor of semen provided to a licensed physician and surgeon or to a licensed sperm bank for use in artificial insemination or in vitro fertilization of a woman other than the donor's wife is treated in law as if he were not the natural father of a child thereby conceived, unless otherwise agreed to in a writing signed by the donor and the woman prior to the conception of the child.Some known donors, particularly those you might find on the Internet, might offer to sign a contract absolving them of parental responsibility and promising not to sue for custody. This is wishful thinking. Family courts can (and have) set aside such agreements as contrary to public policy. Men who offer this should definitely talk to a lawyer: child support belongs to the kid, not to the mother; the mother can't sign it away.Suppose that with the best intentions you write such an agreement and adhere firmly to it. What if something dreadful happens to you? What will the courts do in that case? I wouldn't advise taking the risk.An hour of a lawyer's time generally costs no more than a single sperm bank vial. If you're thinking about using a known donor, it would be money well spent.Now, with all that aside, if you're seeking a co-parent, the fact that you two will be legally entangled may not be as much of a problem. But, you're thinking about co-parenting, please visit a family lawyer experienced with such relationships.2) How do you know the person? Did you meet them online? Or did youknow them earlier?Consider three cases:A male friend.If you can set clear terms for the relationship between you and your donor and your child (which could be anywhere from "none whatsoever" to "basically a second parent"), use a doctor or bank to make sure you don't have to worry about custody battles, and visit a lawyer to make everything official, this could be one of the easiest options. It could also be complicated and awkward. No-one on Quora can answer which, since only you know yourself and your friend.A stranger you met in a bar or club or elsewhere for a one-night stand.If you can talk them into using a doctor or clinic, they're probably going to have to be your friend, given all of the tests they'll have to take. See above. If instead you have sex with them to conceive, see further above, where I explain why this would be a bad idea.Someone you met on the Internet.This is a bit more of a grab-bag. Men who offer sperm on the Internet have a variety of motives. Some have altruistic motives. (Perhaps they had a friend or relative struggle with this issue and wanted to help others.) Others have (as you pointed out) a sexual fetish. Others want to populate the world with their offspring. Others aren't actually serious but are merely curious, and will flake out if you actually want to work with them.And as a trying-to-conceive friend observed: "guys on Craigslist are offering a---service." (To be sure, not all the men offering sperm on Craigslist are just seeking sex, but many are.)If you do meet someone online, follow the usual rules: don't disclose your name or contact details immediately, Skype or phone first, meet in a well-lit public place, et cetera.The Mechanics of Known DonorsSuppose that, via one means or another, you find a known donor. What should you do then?You'll have to find a doctor or sperm bank willing to handle the above California Family Code paperwork. Some sperm banks provide this service for directed (e.g. known) donors, usually for frozen but sometimes for fresh donations. Note that some banks might require a quarantine, particularly if you tell the bank that you and your donor have not been sexually active together, although the FDA requires merely that you know each other---so different clinics may vary. (http://www.fda.gov/BiologicsBloodVaccines/TissueTissueProducts/QuestionsaboutTissues/ucm102842.htm)In all of the above known-donor cases, you'll have to pay for any screening yourself, or ask your donor if he's already done so and if your clinic or doctor will accept those results. Some people are sufficiently motivated to test themselves. (For instance, Trent Arsenault, who has been in the press frequently for offering his sperm free over the Internet, publishes his test results on his website, http://trentdonor.org/>.)A standard STD screening is about $200-$300, depending on what diseases you want to check. (One may not think too often about Chlamydia in the 21st century, but it apparently can cause serious fertility problems.) A semen analysis is $150-$300, depending on what level of detail you request. Genetic counseling and genetic testing costs more still. If you have risk factors, you'll want to check for those, too. (If you and your donor are both Mediterranean, you'll want to be screened for beta-thalassemia, Jewish, for Tay-Sachs, etc.) You'll have to repeat these for each candidate donor.If you opt for IVF, your clinic will probably require more tests. IVF is so invasive and expensive that the clinic will really want to make sure the donor isn't going to cause the procedure to fail.Some related resources, with a heavy Norcal slant:Berkeley Parents Network has some useful advice:http://parents.berkeley.edu/advice/parents/spermdonation.htmlSingle Mothers by Choice, an organization discussed in this New York Times article:http://www.nytimes.com/2006/03/19/magazine/319dad.htmlThere are a bunch of sperm banks in the Bay Area, including:California Cryobank (Palo Alto)Sperm Bank of California (Berkeley)Pacific Reproductive Services (SF)Of course, since sperm banks can ship anywhere in the U.S., the location isn't especially important unless you want to talk to them in person or use them to handle directed donation:Places to find donors online (these are not endorsements; they're just places that I know of):One of many special-purpose social networks:http://knowndonorregistry.com/One of many Yahoo groups (probably the best-moderated of the bunch):http://health.groups.yahoo.com/group/FreeSpermDonors/A Facebook group:http://www.facebook.com/groups/Freespermdonors/Your local Craigslist may have people seeking donors or offering to donate in the "casual encounters", "gigs", or "strictly platonic" sections. Note that Craigslist prohibits traffic in human bodily fluids, so your ad might be quickly flagged, depending on how vigilant the readers are. Casual Encounters is basically the Wild West, so ads asking for or offering sperm might stay up slightly longer there.To sum up:1. Sperm banks are the easiest option, but you don't get to learn as much about the donor.2. Known donors are probably slightly less expensive in terms out of of pocket costs (although your mileage may vary), but you get to find out more about the person. You also have a wider selection---potentially.3. If you do pick a known donor and live in California, for your sake and his, definitely use a doctor or clinic and consult a lawyer.Whatever you decide to do -- good luck!I'm posting anonymously, but if the OP or anyone else would like to askme about this answer, I may be reached at [email protected].

How do I ask for leave directly to the boss?I worked most of my career for the US Federal government. When I was working, a person would request sick leave, annual leave, or LWOP (leave without pay) on a form SF-71. There are Federal procedures in place to ask for LWOP, advanced sick or annual leave, maternity leave, and family leave. There are additional policies in place to ask for leave donations.Many Federal agencies have a handbook in which various policies, including leave, are spelled out. If you are in a unique position in a small office, you may need to request leave for a week or more in advance unless there is either a personal/family emergency. Be truthful. If you have a medical reason, get a document from your physician that supports the time off. If your reason for requesting time off is reasonable and you don’t abuse leave, hopefully you can be accommodated.Regardless of your reason, don’t lie. Workers’ compensation has totally different laws and regulations than any other kind of leave. It must be fully supported by medical documentation. Follow the policies of your agency and office. When I worked for the Navy, we had a case of fraud. The employee in question was lucky not to go to jail and pay a fine. He claimed to have a torn rotator cuff and then bowled in a league. My supervisor obtained a copy of the score sheet and sent it in to the Office of Workers’ Compensation. At the very least, he was required to pay back the leave he was taken and was probably suspended or fired.If you and your supervisor can’t come to an agreement, I recommend that you visit your Human Resources office to discuss the problem with them. If you are a chronic leave abuser, there may be an issue. If you feel that you are being discriminated against, be prepared to provide your EEO office with documentation.REGARDLESS OF THE SITUATION, DON’T JUST DISAPPEAR IF YOU EXPECT TO COME BACK TO THE JOB! Leave is something people earn. They are expected to take a certain amount each year. If you can avoid being out for a lengthy period during the busiest time of the year, I recommend against doing so. If you need at least a week or two off, I recommend submitting your request at least a few months in advance. Most people know several months ahead of time if they are going on a cruise for a few weeks.I only worked a short time in the private sector and was doing temporary work most of that time. I let the organizations know when I was available, and they often found work for me based on my availability.However, the smaller the organization, the more difficult it can be to obtain an extended period of leave.EDIT 09/16/2019: I was the civilian leave officer at the Naval hospital for a few years. My supervisor there never challenged any of the leave that I took for sick purposes. I had documentation, and he knew that I could prove the one hospitalization that I had during that time. In retrospect, although he wasn’t a pushover, he was probably one of the more respectful supervisors that I had. Several tried to challenge my leave for health purposes, even with medical documentation. Most of them found that when I was almost able to cite specific regulations off the top of my head, it was best to avoid challenging me on them, since I would have had them scrutinized by the EEO office and/or Employee Relations. They also didn’t want their ignorance of regulations brought to light.

Stem cell therapy is not without potential complications even when applied by medical doctors who specialize in their use. That being said, the real issue is in “whom” is practicing in stem cell therapies and whether or not they should be. You see, stem cell therapies are fairly “unregulated” meaning that just about anybody can do it…even your chiropractor. And with all the “information(sic)” out there, one is tempted to believe that stem cell therapy has been perfected and available for use on any body part that needs “fixing”, which is far from the truth. That is not to say that stem cell therapies are totally ineffective, it just means that if you are going to engage in their use ensure that the practitioner you choose is very well learned (educated and trained) in their use. That being said:“Orthopedic use of stem cells began about a decade ago. One of the pioneers, Colorado physician Christopher Centeno, who is board certified in physical medicine, rehabilitation, and pain management, founded Regenexx in 2011 as a national physician network offering his stem-cell procedures to treat musculoskeletal problems. One of his group’s research findings is that the optimal total stem-cell count for an arthritic knee is at least 400 million — and while most patients over 60 have enough to treat one knee, most don’t have enough for both knees.Colorado physician Christopher Centeno has been researching orthopedic uses of stem cells since 2005.On his blog, Centeno has written blistering critiques of chiropractor-run stem-cell enterprises, particularly Stem Cell Institute of America, a Canton, Ga.-based firm that shows hundreds of “partner locations” on its online map.The firm claims that its amniotic tissue-based treatment contains “regenerative cells,” but companies that process the donated amniotic tissue dehydrate and irradiate it, which destroys cells. Centeno’s lab verified the absence of cells.“The amniotic fluid they’re selling as a miracle stem-cell cure for arthritis … has no credible data showing it contains viable cells or that it can regrow a new knee,” Centeno wrote on his blog.Chiropractor Brent J. Detelich, who incorporated Stem Cell Institute of America in 2015, did not respond to repeated requests for comment.” Stem cells to fix aching knees, backs: Promising, but no panacea~Also~“If I were considering stem cell treatments, I would seek out experts in stem cell research and hope to enroll in a clinical study; I wouldn’t consult a chiropractic-oriented group that uses a commercial preparation that hasn’t been tested for use in osteoarthritis and that may not even contain any stem cells.Note: I e-mailed Epic Marketing to inquire about how their ads were developed, and how they determined the truth of the statements. They didn’t answer.Posted by Harriet HallHarriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so), and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel. In 2008 she published her memoirs, Women Aren't Supposed to Fly”So, is it safe to use a chiropractor for stem cell therapy? Probably not, the issue being that your local chiropractor is just that-a chiropractor, and will most likely just be following the “directions” given to them by the stem cell provider companies that recruited them…not something I would subject myself to. Although stem cells are “miraculous” in what they are believed to be able to fix, the anomolies they may cause can be worse than the initial problem. So when it comes to “chiropractor office visit stem cell therapy”, caution cannot be overemphasized!